A Remotely Delivered, Aerobic And Resistance Exercise Training Program For Mental Health In Women Living With And Beyond Breast Cancer

PURPOSE: Women living with and beyond breast cancer (LWBBC) who received chemotherapy treatment are at a heightened risk for experiencing poor mental health (i.e., anxiety and depression). The purpose of this two-arm, mixed-methods pilot randomized controlled trial (RCT) was to examine the mental health outcomes of an 8-week, supervised, remotely delivered, combined (i.e., aerobic + resistance) exercise training program versus an active control (i.e., balance + flexibility) in women LWBBC who underwent chemotherapy treatment. METHODS: Women LWBBC were recruited between February-July 2023 through community organizations across Canada. The combined exercise group participated in 3x/wk of 30 min unsupervised aerobic exercise; 2x/wk of 30-min supervised, group-based resistance class +1x/wk recorded class; and four guided, group-based, bi-weekly behavioural counselling sessions. The active control group received 2x/wk of 30-min balance and flexibility class +1x/wk recorded class. All quantitative measures (i.e., primary outcomes of anxiety, depression, and secondary outcomes of self-efficacy, and self-esteem) were obtained at pre-and post-intervention (i.e., 8 weeks). Separate analyses of covariance examined changes in primary and secondary outcomes between groups. Semi-structured interviews were conducted post-intervention and analyzed using thematic analysis. RESULTS: Women LWBBC (N = 21; M = 51.6 ± 7.2 years) were randomized to the combined exercise (n = 10) and active control (n = 11) group and had a mean months since treatment of 11.8 ± 12.9. Improvements with a small effect size in depression (MDiff = -0.89, p = 0.49, ηp2 = 0.03), anxiety (MDiff = -0.08, p = 0.96, ηp2 = 0.00), and self-efficacy (MDiff = 1.41, p = 0.65, ηp2 = 0.01) favoured the combined exercise group, but self-esteem (MDiff = 1.25, p = 0.48, ηp2 = 0.03) favoured the active control group with a small effect size. Women LWBBC discussed improved perceived capability, which translated to feelings of empowerment, greater mood, and ability to cope with stress. CONCLUSIONS:Preliminary evidence suggests that a supervised, remotely delivered, combined exercise intervention may be an effective method to improve mental health among women LWBBC. Future RCTs powered to detect significant improvements in mental health are warranted University of Toronto, Faculty of Kinesiology and Physical Education; PI Startup Funds from Dr. Linda Trinh